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CLIN MED3: GU/Renal > Renal Labs - Fiore > Flashcards

Renal Labs - Fiore Flashcards

1
Q

what is included on a UA

A

Macroscopic and Microscopic evaluation

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2
Q

what are the macroscopic findings on a UA

A

Inspection for color, appearance, odor
measurement of pH, specific gravity, protein, glucose, RBCs, nitrites and WBC

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3
Q

what are the microscopic findings on a UA

A

analysis for casts, crystals, cells

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4
Q

what is the pathologic causes of cloudy urine

A

pyuria
lipiduria

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5
Q

what is the food or drug cause of cloudy urine

A

purine-rich foods

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6
Q

what is the pathologic cause of dark yellow urine

A

concentrated

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7
Q

what is the food or drug cause of dark yellow urine

A

carrots

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8
Q

what is the pathologic cause of orange urine

A

bile

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9
Q

what is the food or drug cause of orange urine

A

pyridium, phenothiazine

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10
Q

what is the pathologic cause of red urine

A

hematuria
hemoglobinuria
myoglobinuria

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11
Q

what is the food or drug cause of red urine

A

rifampin
beets, blackberries, rhubarb

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12
Q

what is the pathologic cuase of brown urine

A

bile
myoglobin

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13
Q

what is the food or drug cause of brown urine

A

fava beans
l-dopa, flagyl, nitrofuratoin

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14
Q

what is the pathologic cause of green/blue (purple bag syndrome) urine

A

multiple bacteria (indwelling catheter)

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15
Q

what is the food/drug cause of green/blue urine

A

amitriptyline, IV cimetidine

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16
Q

what is found on dipstick tests

A

Leukocytes (LEU)
Nitrate (NIT)
Urobilinogen (URO)
Protein (PRO)
pH (pH)
Blood (BLO)
Specific Gravity (SG)
Ketone (KET)
Bilirubin (BIL)
Glucose (GLU)

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17
Q

what correlates with urine osmolality

A

specific gravity

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18
Q

what is low specific gravity indicative of

A

possible acute kidney injury, diabetes insipidus, over-hydration (water)

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19
Q

what is high specific gravity indicative of

A

Dehydration, SIADH, Addisons’

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20
Q

what is the normal pH of urine

A

5.5 - 6.5
usually slightly acidic

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21
Q

what increases acidity of urine

A

proteins and acidic fruit

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22
Q

what increases alkaline urine

A

citrate foods

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23
Q

when is a urine glucose positive

A

serum glucose > 180 mg/dL

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24
Q

what is a by-product found in the urine of RBC breakdown

A

bilirubin

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25
Q

what is indicative of bilirubinuria

A

hepatic disease
choledocholithiasis
pancreatic obstruction

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26
Q

when does urine protein increase

A

diabetic nephropathy, pregnancy (eclampsia), severe exercise, cardiovascular pathology and medications

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27
Q

what is the normal albumin excretion

A

< 30mg/day

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28
Q

what is the screening test of choice for diabetic nephropathy

A

urine albumin to creatinine ratio
- requires a 24-hour collection

29
Q

what should you obtain in high ketonuria

A

serum ketone level

30
Q

what protein are we testing with a protein dipstick test

A

Albumin - less sensitive to other proteins

31
Q

what does microscopic urinalysis detect

A

solid elements
-RBC, WBC, Epithelial cells, Fat, Casts, Bacteria, Fungi, Crystals, Spermatozoa

32
Q

what is Pyruria defined as

A

> 5 WBC/HFP (high powered field)

33
Q

what does squamous epithelial cells on urinalysis suggest

A

contamination
lining of end of urethra and contaminants from vagina

34
Q

what are transitional cells

A

cells from lining of the bladder
usually normal finding

35
Q

what is renal tubular cells on urinalysis suggest

A

pathology
can progress to oval fat bodies: Lipiduria

36
Q

what are Casts

A

clyindirical structures composed of mucoprotein
from distal convoluted tubule or collecting duct of nephron

37
Q

what are the different types of urinary casts

A

hyaline casts
waxy casts
RBC casts
WBC casts
epithelial casts
granular casts
*muddy brown casts
Fatty casts
mixed

38
Q

what are hyaline casts

A

non specific:

mostly normal, low urine flow

39
Q

what are waxy/broad casts

A

advanced/chronic renal disease
cellular casts that remain in the nephron before going towards the bladder

40
Q

what are WBC casts

A

kidney inflammation or infection
-interstitial nephritis
-pyelonephritis

41
Q

what are renal tubular epithelial casts

A

kidney injuyr
-ATN (acute tubular necrosis)
-glomerulonephritis
-nephrotic syndrome
-interstitial nephritis

42
Q

what are granular casts

A

degeneration of epithelial casts
fine vs coarse
may be d/t intense exercise/dehydration in healthy individuals
end stage kidney disease (ESRD)

43
Q

what is pathognomonic for acute tubular necrosis (ATN)

A

Muddy Brown casts
-sloughing of tubular cells
signs of ischemic or toxic injury to kidneys

44
Q

what do high number of fatty casts suggest

A

nephrotic syndrome

45
Q

what is the most common cause of kidney stones

A

calcium oxalate

46
Q

what forms with calcium

A

oxalate - found in green leafy vegetables and other foods

47
Q

what are coffin lid crystals

A

struvite crystals

48
Q

what is the most common medium for urine culture

A

blood agar and MacConkey agar

49
Q

is urine HcG qualitative or Quantitative

A

Qualitative

50
Q

what is a better measurement than specific gravity

A

osmolality

51
Q

what is Urine NAAT (nucleic acid amplification test)

A

1st catch vs clean catch (UTIs)

52
Q

what makes up urea

A

Nitrogen + Carbon + hydrogen + oxygen

53
Q

what does an increase BUN suggest

A

impaired renal function
normal level: 8-18mg/d:

54
Q

what is creatinine excreted by

A

kidneys

55
Q

what is the best measure of kidney function

A

marker of glomerular filtration rate (GFR)

56
Q

what is the breakdown product of creatine phosphate

A

creatinine (Cr)

57
Q

What is the normal BUN level

A

8-18mg/d

58
Q

What is the normal Cr level

A

0.6 - 1.2 mg/dL

59
Q

what is creatinine a indicator of

A

kidney function

60
Q

what is the normal BUN: creatinine ratio

A

10:1

61
Q

what does a BUN:Creatinine ratio of 20:1 suggest

A

pre-renal azotemia
-dehydration
-renal hypoperfusion

62
Q

what does the BUN: Creatinine ratio of less then 20:1 suggest

A

intra-renal azotemia
-acute tubular necrosis

63
Q

what does the BUN: Creatinine ratio help determine

A

the cause of Acute Kidney Injury (AKI) or kidney failure

64
Q

what is the normal GFR

A

> 90 ml/min/1.73m^3

65
Q

what is the GFR value that is indicative of dialysis

A

< than 15 eGFR

66
Q

what can cystatin C be used to evalute

A

renal function

67
Q

what is Renin stimulated by

A

reduced blood volume and renal blood flow

68
Q

what inhibits renin

A

sodium and water retention

CLIN MED3: GU/Renal (11 decks)

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